摘要
我院急诊监护室七年共收入多发伤病人146例，占同期创伤病人的37．8％。男性108例，女性38例，年龄5-76岁，以交通意外伤和高处坠落伤为多。本文采用1974年Owaga修正制订的创伤指数对146例多发伤病人进行了分析总结，发现创伤指数与并发症发生率、病死率均成直线正相关关系，其相关系数分别为0．997和0．966（P＜0．05）。存活组118例，平均创伤指数为21．3±5．1，死亡组28例，平均创伤指数为27±4．4，两组比较，创伤指数有显著位差异（P＜0．01）。并发症以休克、急性呼吸功能衰竭最为常见。作者认为，创伤指数能较准确地评估伤情、指导治疗、反映预后，值得在抢救现场和救护车上推广。迅速全面地查明伤情是诊治严重多发伤的关键，CT、B超、胸腔穿刺是快速、简便、准确的诊断方法。作者强调，严重多发伤的快速抢救，有效止血和大剂量广谱抗生素的早期应用是救治成功的关键。
146 patients, male 108, female 38, age ranged from 5 - 76, with multipletrauma admitted to Emergency Intensive Care Unit (EICU) of our hospital from January1985 to May 1995, which accounts for 37. 8% of all trauma cases at that time, the traffic ac-cidents and high flings are the two leading causes. The mortality and morbidity of complica-tion are positive linear correlated with the Owaga trauma index(TI) modified in 1974 and thecorrectative coefficient: r= 0. 977 and 0. 966 (P＜0.05), respectively. The mean score of TIof 118 survival cases and 28 dead cases afe 21. 3± 5. 1 and 27. 0± 4. 4, respectively, with sig-nificant statistic difference (P<0.01 ). The most common complication of these multipletrauma patients are shock and acute respiratory failure. The TI should be widely used to eva-lute the degree of trauma, to guide the treatment， and to predicate the prognosis in traumaemergency situation. The key is to find out the multiple trauma condition rapidly and entire-ly, and the CT image, B-type ultrosound scanning, and thoracentesis are three kinds of use-ful method to diagnosis. This paper was quite emphatic on the points of rescue, effectivehemostasis and using of large dosage wide spectum antibiotics as quickly as possible, oncethe diagnosis having been made.
出处
《急诊医学》
CSCD
1995年第3期167-171,共5页
关键词
交通意外伤
多发伤
胸腔穿刺
止血
急诊
traffic accident high falling multiple trauma trauma index thoracentesis hemostasis
